Native heart valve leaflets with layered fibrous structures show anisotropic characteristics,allowing them to withstand complex mechanical loading for long-term cardiac cycles.Herein,two types of silk fibroin(SF)fiber...Native heart valve leaflets with layered fibrous structures show anisotropic characteristics,allowing them to withstand complex mechanical loading for long-term cardiac cycles.Herein,two types of silk fibroin(SF)fiber membranes with anisotropic(ASF)and isotropic(ISF)properties were prepared by electrospinning,and were further combined with poly(ethylene glycol)diacrylate(PEGDA)hydrogels to serve as polymeric heart valve(PHV)substitutes(PEGDA-ASF and PEGDA-ISF).The uniaxial tensile tests showed obvious anisotropy of PEGDA-ASF with elastic moduli of 10.95±1.09 and3.55±0.32 MPa,respectively,along the directions parallel and perpendicular to the fiber alignment,while PEGDA-ISF possessed isotropic property with elastic moduli of 4.54±0.43 MPa.The PHVs from both PEGDA-ASF and PEGDA-ISF presented appropriate hydrodynamic properties from pulse duplicator tests according to the ISO 5840-3 standard.However,finite element analysis(FEA)revealed the anisotropic PEGDA-ASF valve showed a lower maximum principle stress value(2.20 MPa)in commissures during diastole compared with that from the isotropic PEGDA-ISF valve(2.37 MPa).In the fully open state,the bending area of the PEGDA-ASF valve appeared in the belly portion and near the attachment line like native valves,however,which was close to free edges for the PEGDA-ISF valve.The Gauss curvature analysis also indicated that the anisotropic PEGDA-ASF valve can produce appropriate surface morphology by dynamically adjusting the movement of bending area during the opening process.Hence,anisotropy of PHVs with bio-inspired layered fibrous struc-tures played important roles in mechanical and hydrodynamic behavior mimicking native heart valves.展开更多
OBJECTIVES: We aimed to test the diagnostic accuracy of cardiovascular magnetic resonance(CMR) imaging in distinguishing pathological left ventricular non-compaction(LVNC) from lesser degrees of trabecular layering se...OBJECTIVES: We aimed to test the diagnostic accuracy of cardiovascular magnetic resonance(CMR) imaging in distinguishing pathological left ventricular non-compaction(LVNC) from lesser degrees of trabecular layering seen in healthy volunteers and, in those with cardiomyopathies and concentric left ventricular hypertrophy, potential differential diagnoses. We hypothesized that pathological trabeculation could be distinguished by determining the ratio of non-compacted to compacted myocardium(NC/C ratio). BACKGROUND: Left ventricular non-compaction is characterized by a non-compacted myocardial layer in the left ventricle. Cardiovascular magnetic resonance images this layer with unprecedented quality, particularly in the ventricular apex, where echocardiography has inherent difficulties. METHODS: We analyzed magnetic resonance cine images, using the 17-segment model in 45 healthy volunteers, 25 athletes, 39 patients with hypertrophic cardiomyopathy and 14 with dilated cardiomyopathy, 17 with hypertensive heart disease, and 30 with aortic stenosis, as well as images from 7 patients previously diagnosed with LVNC whose diagnoses were supported by additional features. RESULTS: Areas of non-compaction were common and occurred more frequently in all groups studied in apical and lateral, rather than in basal or septal, segments. A NC/C ratio of >2.3 in diastole distinguished pathological non-compaction, with values for sensitivity, specificity, and positive and negative predictions of 86%, 99%, 75%, and 99%, respectively. CONCLUSIONS: Left ventricular non-compaction is diagnosed accurately with CMR using the NC/C ratio in diastole.展开更多
基金supported by the National Natural Science Foundation of China (31300788)the Hundred-Talent Program from Chinese Academy of Sciences
文摘Native heart valve leaflets with layered fibrous structures show anisotropic characteristics,allowing them to withstand complex mechanical loading for long-term cardiac cycles.Herein,two types of silk fibroin(SF)fiber membranes with anisotropic(ASF)and isotropic(ISF)properties were prepared by electrospinning,and were further combined with poly(ethylene glycol)diacrylate(PEGDA)hydrogels to serve as polymeric heart valve(PHV)substitutes(PEGDA-ASF and PEGDA-ISF).The uniaxial tensile tests showed obvious anisotropy of PEGDA-ASF with elastic moduli of 10.95±1.09 and3.55±0.32 MPa,respectively,along the directions parallel and perpendicular to the fiber alignment,while PEGDA-ISF possessed isotropic property with elastic moduli of 4.54±0.43 MPa.The PHVs from both PEGDA-ASF and PEGDA-ISF presented appropriate hydrodynamic properties from pulse duplicator tests according to the ISO 5840-3 standard.However,finite element analysis(FEA)revealed the anisotropic PEGDA-ASF valve showed a lower maximum principle stress value(2.20 MPa)in commissures during diastole compared with that from the isotropic PEGDA-ISF valve(2.37 MPa).In the fully open state,the bending area of the PEGDA-ASF valve appeared in the belly portion and near the attachment line like native valves,however,which was close to free edges for the PEGDA-ISF valve.The Gauss curvature analysis also indicated that the anisotropic PEGDA-ASF valve can produce appropriate surface morphology by dynamically adjusting the movement of bending area during the opening process.Hence,anisotropy of PHVs with bio-inspired layered fibrous struc-tures played important roles in mechanical and hydrodynamic behavior mimicking native heart valves.
文摘OBJECTIVES: We aimed to test the diagnostic accuracy of cardiovascular magnetic resonance(CMR) imaging in distinguishing pathological left ventricular non-compaction(LVNC) from lesser degrees of trabecular layering seen in healthy volunteers and, in those with cardiomyopathies and concentric left ventricular hypertrophy, potential differential diagnoses. We hypothesized that pathological trabeculation could be distinguished by determining the ratio of non-compacted to compacted myocardium(NC/C ratio). BACKGROUND: Left ventricular non-compaction is characterized by a non-compacted myocardial layer in the left ventricle. Cardiovascular magnetic resonance images this layer with unprecedented quality, particularly in the ventricular apex, where echocardiography has inherent difficulties. METHODS: We analyzed magnetic resonance cine images, using the 17-segment model in 45 healthy volunteers, 25 athletes, 39 patients with hypertrophic cardiomyopathy and 14 with dilated cardiomyopathy, 17 with hypertensive heart disease, and 30 with aortic stenosis, as well as images from 7 patients previously diagnosed with LVNC whose diagnoses were supported by additional features. RESULTS: Areas of non-compaction were common and occurred more frequently in all groups studied in apical and lateral, rather than in basal or septal, segments. A NC/C ratio of >2.3 in diastole distinguished pathological non-compaction, with values for sensitivity, specificity, and positive and negative predictions of 86%, 99%, 75%, and 99%, respectively. CONCLUSIONS: Left ventricular non-compaction is diagnosed accurately with CMR using the NC/C ratio in diastole.
